Individual
MR. GEORGE MTUWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17400 BRANDEL AVE, SOUTH BEND, IN 46635-1255
(317) 333-4074
Mailing address
17400 BRANDEL AVE, SOUTH BEND, IN 46635-1255
(317) 333-4074
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17400
—
IN
Enumeration date
12/02/2021
Last updated
12/02/2021
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